"...and to All a Good Night": Advancing Sleep Health as an Essential Vital Sign!

Sleep and sleep disorders are rapidly becoming a major component in the care of patients in today's health care system.  Unfortunately, nursing practice and nursing education have not maintained the same pace of importance in considering sleep as a component of nursing care.  Research has validated the relationship of sleep and overall physical, mental, and spiritual health.  The research literature is full of studies that link sleep disorders such as obstructive sleep apnea with major disorders such as diabetes, hypertension, obesity, and respiratory disorders (Kryger, 2011; Morgenthaler, 2015; Caruso, 2010; Peppark, 2013). It is now time for nursing practice and nursing education to review curricula and include evidence-based knowledge in nursing education programs at all levels so that practicing nurses can become proficient in the assessment, planning, and implementation of care for patients experiencing sleep problems.

Nurses across the world are familiar with the common vital signs that are assessed in each patient they care for within their work day. The first thing nursing students learn in a skills lab is how to determine a pulse, blood pressure, respiratory rate, and body temperature.  They also learn to assess for the presence of pain, commonly called the fifth vital sign.  This presentation creates a strong case for including yet a sixth vital sign: the status of sleep quality.  Sleep quality, which can be assessed through a variety of tools can be determined by the nurse who is educated in the physiology of sleep and the impact of poor sleep on overall health.  Nurses working in primary care, in a hospital setting, or in the community have access to patients who likely experience the common sleep disorders such as insomnia, obstructive sleep apnea, narcolepsy, or restless leg syndrome.  All of these common sleep disorders affect the quality of life for patients afflicted by them; yet the nurse does not have the knowledge, skills, or awareness to integrate the appropriate interventions to provide better patient outcomes.  If sleep was acknowledged as a critical "sixth vital sign", patient health outcomes would improve and outcomes of chronic disorders such as diabetes, hypertension, and obesity could also benefit.

In order to prepare a workforce of nurses who is knowledgeable in sleep care, nursing education programs at all levels must begin to include sleep theory and care into the nursing curriculum at the registered nurse and advanced practice levels.  At the advanced practice level, there is an actual potential for caring for patients with sleep disorders to become a specialty or a subspecialty within a broader specialty disorder such as cardiac care or psychiatric/mental health.

This presentation will encourage the learner to consider the assessment of sleep as the sixth vital sign and will provide the rationale for this initiative.  Let's bring nursing practice to the cutting edge of patient care as sleep is recognized a having a vital impact on overall health of individuals across the lifespan.